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Antibiotics

Dalal, Kavitha S. PharmD; Bridgeman, Mary Barna PharmD, BCPS

doi: 10.1097/01.NURSE.0000512891.59999.f5
Department: DRUG CHALLENGE
Free

Kavitha S. Dalal is a critical care pharmacist at Virtua in Marlton, N.J. Mary Barna Bridgeman is a clinical associate professor at Rutgers University Ernest Mario School of Pharmacy in Piscataway, N.J.

Unless otherwise specified, the information in the preceding summaries applies to adults, not children. Consult the package insert for information about each drug's safety during pregnancy and breastfeeding. Also consult a pharmacist, the package insert, or a comprehensive drug reference for more details on precautions, drug interactions, and adverse reactions.

Can you identify these antibiotics indicated for acute bacterial skin and skin structure infections (ABSSSI)? To find out, match each brand name in Section I with its generic name in Section II.

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Section I

_____ 1. Dalvance (Durata Therapeutics)

_____ 2. Sivextro (Cubist Pharmaceuticals U.S.)

_____ 3. Orbactiv (The Medicines Company)

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Section II

a. dalbavancin. This glycopeptide antibiotic is indicated to treat adults with ABSSSI caused by certain Gram-positive microorganisms, including Staphylococcus aureus, Streptococcus pyogenes, Streptococcus anginosus group, and Streptococcus agalactiae. It's administered as a single-dose regimen of 1,500 mg, or as a two-dose regimen of 1,000 mg followed by 500 mg 1 week later. Each dose is administered by I.V. infusion over 30 minutes. The dosage should be reduced in patients with renal impairment. If using a common I.V. line, flush the line before and after administration of dalbavancin with 5% Dextrose Injection; the drug is incompatible with sodium chloride.

b. oritavancin. Also classified as a glycopeptide antibiotic, this drug is administered as a single I.V. dose of 1,200 mg infused over 3 hours. Use of I.V. unfractionated heparin sodium is contraindicated for 5 days after administration of oritavancin because activated partial thromboplastin time test results may be falsely elevated during that period. The most common adverse reactions to oritavancin include nausea, headache, vomiting, limb and subcutaneous abscesses, and diarrhea. Like other glycopeptide antibiotics, oritavancin can cause serious hypersensitivity reactions.

c. tedizolid phosphate. This oxazolidinone antibiotic can be administered either orally or via I.V. infusion once daily for 6 days to treat adults with ABSSSI caused by susceptible Gram-positive bacteria. Administer an I.V. infusion over 1 hour. If using a common I.V. line, flush the line with 0.9% sodium chloride before and after administration of tedizolid. Teach patients that oral tedizolid can be taken without regard to food. If they miss a dose, they should take it as soon as possible up to 8 hours before the next scheduled dose. If less than 8 hours remain, they should wait to take the next scheduled dose.

References available upon request.

ANSWERS: 1a, 2c, 3b

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